[Congressional Record Volume 149, Number 055 (Monday, April 7, 2003)]
[House]
[Pages H2852-H2856]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          HISPANIC HEALTH CARE

  The SPEAKER pro tempore (Mr. Burgess). Under the Speaker's announced 
policy of January 7, 2003, the gentleman from Texas (Mr. Rodriguez) is 
recognized for 60 minutes.
  Mr. RODRIGUEZ. Mr. Speaker, thank you for allowing the opportunity to 
be here tonight.
  This month is health care month and I wanted to take the opportunity 
to come up here tonight to talk a little bit about health care. And as 
chairman of the National Hispanic Congressional Caucus, I wanted to 
specifically emphasize Hispanic health care. I want to thank also my 
colleagues who are both on the Hispanic Caucus who have been working 
extremely hard in the area of health care, the gentlewoman from 
California (Ms. Solis) and the gentleman from Texas (Mr. Gonzalez) and 
others.
  Hispanics are now the fastest-growing population in the United States 
and comprise 13 percent of the total population. Yet they continue to 
suffer disproportionately from health disparities and face many 
barriers in access to quality health care. Over 33 percent of the 
Hispanics are uninsured. That is one out of every three find themselves 
without access to insurance, compared to 10 percent of the non-Hispanic 
whites. Let me just add that the uninsured population continues to 
grow, continues to become even worse as with the economy as well as 
with the fact that we have not been supportive of some of those 
programs.
  And I would also add that those people who are uninsured are the ones 
that are out there. They are working Americans trying to make ends meet 
but find themselves working in small companies, find themselves working 
in rural America, find themselves not working for a major corporation 
or governments, so they find themselves without access to insurance. 
Yet, they are working. They do not qualify for Medicaid because they 
are not poor enough because they are making money, but then they do not 
qualify for Medicare either because they are not senior enough. So here 
they are in between, working Americans, yet find themselves unable to 
afford health care. Yet in a country that has the best health care 
system in the world, it is not affordable; and it is not accessible to 
working Americans.
  When it comes to children, the numbers are equally sad. Hispanic 
children have the highest uninsured rate in the United States, with the 
child population one out of every four, 24.1 percent. So we have a 
situation that not only hits the uninsured but it also hits the most 
vulnerable, our children. Over 35 percent of all Hispanic children 
depend on State Children's Health Insurance, or what we have call the 
SCHIP program, for health care needs.
  We know that the uninsured have limited access to care. And we also 
know that the uninsured suffer disproportionately from diseases that 
can be prevented, treated and even cured. And that is what is so sad, 
some of these diseases can be prevented; some of these diseases can be 
treated and some can be cured. And then I look at the numbers where I 
see the statistics that show that in 1 year an estimated 2 million 
Hispanics were diagnosed with diabetes and another 1 million were 
estimated to have undiagnosed diabetes. And so here now we have the 
data to be able to diagnose diabetes at a very early age. We have the 
information. We have the potential of making a difference. We have the 
capability of being able to provide the data that is needed.
  And I want to let you know that in the area of diabetes, I have been 
well educated in that area. When I served in the Texas House, I was in 
the public health committee, and I recall very distinctly finding out 
the data. When we looked at the disease, diabetes, at the number of 
people that go blind, the number of amputees usually as a result of 
diabetes, a large percentage of them, and, ironically, enough, in those 
areas it is an area that can be prevented, especially now that we can 
diagnose it at an early age, where we can work with those youngsters, 
work with those families so they do not have to suffer later on where 
they might lose a limb or go blind.
  We also have when we see statistics that show 20 percent of persons 
living with AIDS are Hispanics, we know we have a serious problem if we 
do not start to address the state of Hispanic health with targeted 
prevention programs, treatment programs. With the strains that the 
health care system is currently experiencing, then we will have even 
more dramatic problems.
  In the area of AIDS, we have made some significant strides. In fact, 
the data show that the numbers overall have been going down, and that 
is good and the statistics have shown it. But when it comes to 
minorities, especially African American and Hispanics, we find within 
ourselves it is growing disproportionately. And so AIDS has not gone 
away. It is still there. It is still a killer, and it is still one of 
the areas that we need to concentrate on. And it is also an area where 
we identify it as one of those infectious diseases such as tuberculosis 
that we really need to concentrate on, no matter whether it exists in 
this country or anywhere else. So eventually we will have to deal with 
it. So it becomes important that we zero in on AIDS and see what we can 
do.

  One of things I wanted to mention about AIDS is that in our Hispanic 
community throughout this country one of the difficulties is that a lot 
of communities have what we call community-based organizations, and we 
have a few but our programs were not initially, we do not have as many 
as other community groups do. And so you find in the Hispanic community 
a lack of community-based organizations that are not funded. You have 
some groups, but they do not have sufficient resources. And so when 
they try to compete for the Federal dollars, for the State dollars, 
they find themselves a disadvantage because they were not there from 
the very beginning; they were not there when these other organizations 
were given these seeds monies to be able to start those programs to be 
able to make a difference.
  I also wanted to take this opportunity also to talk a little bit 
about the Hispanic Health Improvement Act. Through the caucus, we 
organized, the Hispanic Congressional Caucus, has organized based on 
task forces. We have a task force that is headed by the gentlewoman 
from California (Ms. Solis), but we have worked on that task force to 
come up with our own Hispanic Health Improvement Act; and we have been 
working on this for some time now. It is a comprehensive bill aimed at 
improving Hispanic health in the United States. The legislation offers 
a variety of strategies for expanding health care coverage, for 
improving access and affordability, which is key, for also reducing 
health disparities as well as strengthening our Nation's health care 
workforce.
  Let me just add that this particular piece of legislation is a piece 
of legislation that I have personally been working on for a little bit 
since I came up here almost 6 years ago; and it has evolved into a 
piece of legislation that is pretty comprehensive over all and touches 
on a lot of areas that the Hispanic community has been encountering and 
the difficulties in the disparities. One of the things that we did 
about a year ago was we did a conference where we asked every Member, 
both Republican and Democrat, that had any significant number of 
Hispanics in their districts, we invited them to a conference, and we 
had the conference in San Antonio. We had great participation, not only 
from the legislature, but also from each of the Members' staff. We 
invited one or two members from each of the staffs. And there we were 
able to come up with additional recommendations that were extremely 
helpful in beginning to finalize our piece of legislation and begin to 
address the responses that we needed in order to make that happen.
  This legislation provides for the expansion of the successful State 
Children's Health Insurance Program, which is known as SCHIP, to cover 
the uninsured low-income pregnant women and parents. Right now the 
SCHIP as we well know does not cover women that are pregnant, that are 
uninsured; and we also know the importance of

[[Page H2853]]

covering them is key. It also provides the flexibility to States that 
want to enroll legal permanent resident children and pregnant women. 
And once again, these are legal permanent resident children and 
pregnant women. We do not have that in the present legislation, and it 
is important. It is important that that also occurs. There must also be 
flexible incentive for States to increase enrollment in times of 
economic recession and as the population increases.
  It is important, the proposal, that the administration has right now 
is to basically take the SCHIP program, the Medicaid program and what 
we call the disproportional share and put it into one lump sum, which 
is most of the needy programs in this country, and then send it to the 
States but then it caps it. Our program allows for the flexible 
incentive that if the numbers increase, you are able to put additional 
resources. Especially in those areas where the population is growing, 
it is important that we provide access to that capability. And we know 
that population fluctuates every 10 years or so because we draw our 
lines based on that for political representation. So we also know that 
the numbers of the ones that are in need also grow.
  The legislation also addresses the future needs of our health care 
system and provides increased funding for health resources services, 
administration health professions, diversity programs; and we must 
ensure that our health care system can provide both linguistically and 
culturally appropriate health care. You might say, well, what does that 
mean? I just want to give one example. I recall a couple of years ago, 
it has been about 3 years ago when we had a hearing and I remember some 
testimony that was provided by one of the doctors who said that she had 
a client, and during that hearing she indicated that the client had 
been informed that she had been positive for AIDS. But in Spanish it 
was translated AIDS is positivo. If you just tell someone they are 
positive without explaining in Spanish as to what it means in terms of 
what it means to be positive, in Espanol you say ``esta positivo,'' 
that means everything is okay.
  So when you just get it in writing, she assumed that everything was 
okay. Well, that particular patient had a child and contracted AIDS. 
And so we have got to be able to communicate. We have got to be able to 
reach out. And a lot of times our health professionals might not be 
both linguistically or culturally appropriate in terms of being able to 
communicate, and sometimes our education assumes a great deal on the 
part of the patient, and that needs to be considered.
  These programs also promote diversity and support training 
professionals in the fields that are currently experiencing shortages. 
The bill also targets approaches that will help improve the health care 
of Hispanic communities in those areas and to make sure we address some 
of those needs.
  Let me take this opportunity to talk a little bit more about our 
piece of legislation because when we talk about the importance of 
shortages in our Nation's health care, the bill begins to look at 
addressing the needs of what exists. And we know that right now there 
are thousands and thousands of nurses that are needed. We need nurses. 
And we need to make sure that we have the resources to make that 
happen. So this bill calls for beginning to look at providing those 
resources to make that happen. We have got to begin to educate our 
health care professionals. We have got to produce our own health care 
professionals. We need doctors.
  Let me give an example, and I think I have shared this before, but I 
have got to keep saying it because we still do not do anything about 
it.

                              {time}  2200

  We always complain about immigration. We always indicate that there 
are too many people coming from abroad, and prior to 9/11, we had a 
little less than 300,000 people come from abroad. This is the 
professional category, 300,000.
  In that category, Mr. Speaker, we have approximately 5,000 doctors. 
If we look at the data, Mr. Speaker, we graduate 12- to 13,000 each 
year; yet, we bring in 5,000 doctors each year. We are a brain drain on 
the rest of the world.
  At the same time, we tell people, young people who want to go into 
medical school, to qualify, we tell two of them, sorry, we do not have 
any room for them. So at some point we have to produce our own. We have 
got to produce more doctors, more health care professionals. We need 
more dentists and pharmacists. We need more nurses, and so we need to 
begin to provide those opportunities for some of our people in this 
country to be able to provide that access that is needed.
  In addition to that, the bill also calls for improving access and 
affordability to medically underserved areas. The border area is one of 
the most underserved areas in the Nation, and it is an area that 
requires a great deal of help. It is an area that requires a great deal 
of assistance, and we need the resources to provide access to health 
care.
  I represent San Antonio down to the Mexican border where I have La 
Salle, Zapata, Starr and Hidalgo, and in those counties there was a 
recent study that has just been done. In fact, I am going to have a 
chance to meet the author and discuss it. It is a good friend of mine, 
and we will discuss the findings; but Dr. Ortiz was telling me that on 
the survey that he had done of individuals in Hidalgo County, as I 
recall, and there might be some from Starr County also, that is also on 
the border, that when they were asked, where did they get access to 
their health care, 50 percent of them, they were Americans who were 
asked, where do they get their access to health care, it was in Mexico.
  We complained about people coming from Mexico, accessing our 
services, and yes, they do come over and access our service, but a 
large percentage of them also go to Mexico to access service, both for 
prescription drugs, for dental services and for just general health 
care.
  So it is important to note that we still in this country have not 
been able to meet the needs in those underserved areas. Our rural 
America is having a great deal of difficulty getting access to good 
quality care. With the advent of the HMOs and the health care systems, 
those systems are unwilling to go into rural America because they do 
not see the profits there. They do not see the way they are going to be 
able to make a profit, and most of them find themselves in urban areas. 
So rural areas, the options are very limited to some of the 
constituencies in our rural communities throughout this country.
  There is a real need, and this particular bill provides some 
resources to begin to look at those underserved areas and begin to 
provide access to be able to get those resources.
  Also, thirdly, the bill increases resources that are needed to combat 
Hispanic health disparities. I want to take this opportunity to talk 
about a couple of those disparities.
  One of them is the area of diabetes, and I know I mentioned to my 
colleagues earlier that diabetes is a very important issue that 
confronts Latinos and others, but I wanted to just mention some of the 
statistics in the area of diabetes.
  In 2000, an estimated 2 million Hispanics had been diagnosed with 
diabetes, and another 1 million are estimated to have undiagnosed 
diabetes. Approximately 10 percent of all Hispanics have diabetes; that 
is one out of 10. That is a pretty significant number when we see one 
out of 10 Hispanics that suffer from diabetes. For those that are 50 or 
older, the data goes up to 30 percent that have diabetes. So as they 
reach the age of 50, it is 30 percent. That is almost three out of 10. 
So it increases dramatically.
  Hispanics, on the average, are almost two times more likely to have 
diabetes than non-Hispanic whites. So diabetes is definitely an area 
that we really need to look at, an area that we really need to 
concentrate on, and I am hoping that we are able to get the resources 
that we are asking under the Hispanic Health Improvement Act to be able 
to respond to those needs.
  Remember that this is an issue and this is an illness and a disease 
that causes people to lose their limbs. It causes people to go blind, 
and their quality of life is hampered. It is an area that in a lot of 
cases can be prevented, and there are some beautiful programs out 
there. Dr. Trevino's program in San Antonio that works with kids in the 
San Antonio ISD school district and others, these are good programs, 
viable programs.

  I have been blessed that in my district, in Starr County was where 
some

[[Page H2854]]

of the first studies that were done in the area of diabetes, where they 
are able to now identify those youngsters in elementary school that 
have the signs or the possibility of diabetes; and so we need to make 
sure that we go forward in that area.
  The other area that I have mentioned to my colleagues that is also a 
disparity that I would like to just kind of address a little more, and 
that is the area of both HIV and AIDS. Twenty percent of persons living 
with AIDS are Hispanic, 20 percent, despite the fact that we only 
represent 13 percent of the population. So we see the disparity, and 
that 20 percent is significant.
  The AIDS incidence rate per 100,000 population, the number of new 
cases of diseases that occurred during a specific time period among 
Hispanics in 2000 was 22.5, more than three times the rate for whites. 
So in the area of AIDS, we are disproportionately hit, and according to 
projections made by the Harvard School of Public Health, by the year 
2050, the number of new AIDS cases among Hispanics will surpass that of 
whites. When it comes to AIDS and HIV, we have an area that we really 
need to begin to look at how we are going to concentrate, how we are 
going to be looking at meeting some of those needs of those 
individuals.
  Once again, there is need for basic grants to start up those 
community-based organizations that do not exist in our communities. 
They exist in some of the other communities, but in ours, we still do 
not have the community-based organizations.
  The other areas of disparity are the issues regarding cancer, the 
issues of asthma, substance abuse and mental health. Let me briefly, in 
the area of mental health a number of studies suggest that the mental 
health of Hispanics decreases as Hispanics adapt to the U.S. way of 
life. That is kind of interesting, that as they become more 
Americanized, the mental health problems supposedly decrease. Hispanic 
youth experience, proportionately, more anxiety-related though, and 
delinquency problem behaviors with both depression and drug use than do 
non-Hispanic white youth. In fact, many refugees from Central America 
experience kind of trauma-related traumas in the homelands where they 
come from with the civil wars, and so a lot of them are suffering from 
post-traumatic stress disorders.
  It is one of the areas that we know especially with our veterans that 
it is something that needs to be worked on. It is something that needs 
to be treated, and it is similar to, for example, what happened in New 
York after 9/11. There is no doubt that we ought to be working with a 
lot of New Yorkers there and the families because of the issue of post-
traumatic stress disorder, and it is something that stays with someone.
  If anyone has gone through any experience such as that, it is 
something that changes their life. It is something that dramatically 
causes a person to change, and in some ways, they are even 
unconsciously doing certain things without realizing why they are doing 
it and why they think in certain ways because of the impact of that 
traumatic experience.
  So it applies not only to veterans in the war, but it also applies to 
things that we witness, things that we have experienced. So post-
traumatic stress disorders among young Latinos also has increased, 
along with the issue of depression.
  Among Hispanics with mental disorders, fewer than one in 11 contact 
mental health specialists. So a lot of Hispanics who do suffer from 
mental health difficulties do not contact for assistance, are not in 
our mental health programs throughout this country, are not getting the 
service that they need, while fewer than one in five contact general 
health care providers, but one in 11 failed to contact.
  Among Hispanic immigrants with mental disorders, fewer than one in 20 
use the services. So the numbers go even lower as they first come into 
this country. They tend not to utilize the services.
  Let me talk a little bit on mental health. Mental health is one of 
the areas that for some reason in this country, just like in health 
care, but more so in mental health, it is an area that we have been 
reluctant to fund. It is an area that we have been reluctant to provide 
assistance to, an area where a lot of our youngsters suffer from 
depression, where a lot of our women suffer from depression, where we 
have forgotten quickly what happened at Columbine, and so those things 
are still there. Those problems still exist, and there is a need for us 
to reach out to our young people. There is a need for us to work with 
our communities and our schools to see how we can help, and there is 
really a need for us to reach out.
  There is data to show that Latinos, Hispanics, a large number of 
them, in fact, the number of suicides among Latinos is growing. So it 
is an area that we need to really kind of look at real close. So I 
wanted to make sure that I emphasize that our program also talks about 
the mentally ill as well as substance abuse.

  Let me also briefly talk about another disease which is heart 
disease. Heart disease claims the lives of 30 percent of, more than 
107,000, Hispanic Americans who die each year, 107,000, 30 percent are 
Hispanics. Among Mexican American adults, about 29 percent of men and 
27 percent of women have cardiovascular diseases. Among those with high 
blood pressure, Mexican Americans are much less likely than non-
Hispanic whites and non-Hispanic blacks to be aware of it and be 
treated. So not only do they have high blood pressure, but a large 
number of them are not even aware of the problem, and they feel okay or 
think they feel okay and they continue to act in the way they do, and 
so they are unable to get it treated.
  It becomes real important that we provide the preventive care that is 
needed, to provide the access to those services that are important.
  So I wanted to emphasize those specific programs that we have and 
indicate the importance of that.
  Let me also take this opportunity to also talk briefly about the 
prescription drug coverage. For access to health care, we know at one 
time, when both Medicaid and Medicare were established, we could have 
argued, well, prescriptions were maybe not that important at that time. 
Although for our indigent, we have provided access to prescription drug 
coverage, but we have not done that for Medicare, and I know that the 
President has come up with a proposal on Medicare for prescription 
drugs, but we also know that that proposal is inadequate, and everyone 
knows it and everyone recognizes that.
  It is a proposal that is just out there that is a facade, that does 
not really address the needs of our seniors that are suffering from 
Medicare.
  For Hispanics, most of our Hispanic Americans that find themselves in 
their twilight years, the majority only have Social Security and 
nothing else and find themselves only with Medicare and no Medicare-
Plus or any other, and so it becomes real important that we start to 
begin to look at a prescription drug plan that helps to address the 
needs of our seniors and our seniors are in need.
  Our seniors are having a great deal of difficulty, and every time I 
go to a senior citizen center, every time I am at church, people will 
approach me about the importance of prescription drugs and the 
importance of making it accessible to our seniors.
  The ironical thing about it is, once again, here we have a country 
that has come up with some beautiful health care programs, some 
beautiful responses to some of our diseases; yet our people do not have 
access to them and they are not affordable.
  So I would ask what good does it do to have all the information, all 
the good prescriptions that are out there to address the needs of some 
of our problems when people do not have access to them, and they are 
not affordable?

                              {time}  2215

  So there is a real need for us to reach out to those seniors and make 
that accessible.
  The importance of the prescription drugs to our seniors is key. We 
know that that is one of the main ways of addressing the needs of our 
seniors. We know that that is one of the few ways that they can deal 
with their problems. So it becomes important that we come up with a 
program that addresses the need of prescription drug coverage for our 
seniors, and we know that the President's proposal is not adequate.
  The Bush budget basically sacrifices the health of our Nation to 
provide tax

[[Page H2855]]

cuts for the wealthiest 1 percent. The Bush budget fails to adequately 
address the problems of the 41 million Americans that find themselves 
uninsured. Nearly 25 percent of all uninsured are children. Even 25 
percent of the moderate-income families cannot afford health insurance. 
And eight out of 10 uninsured Americans are working individuals. We 
have to keep that in mind. These are people that are trying to make 
ends meet. These are people trying to work to go after that American 
dream, yet finding themselves without health insurance, unable to 
provide the resources when they do find themselves in need of 
medications.
  I wanted to stress one more time that in the area of health care for 
our seniors we find ourselves in the Congress and in the administration 
with an unwillingness to respond to a program that addresses their 
needs. We ought to recognize that the private sector has even indicated 
that they cannot make a profit from our seniors, Mr. Speaker. We know 
that they spend a little bit over $1,000 on prescriptions, and we know 
that the private sector has a rough time. The only ones they can make a 
profit on are those healthy seniors that find themselves in a situation 
where they are not that sick. But as soon as they do get sick, they are 
not good for our insurance companies because they cannot make a profit.
  And that is fine, Mr. Speaker. Insurance companies are there as a 
for-profit operation. They are there to make a profit. So we should not 
expect them to provide access to our seniors. But it is the 
responsibility of the government to provide for its most vulnerable. 
These individuals have been there for us in the past. These individuals 
have worked all their lives. Now it is our obligation and our 
responsibility to provide for access to that health care.
  In the same dialogue, when we talk about health care, I wanted to 
take this opportunity to also talk about our veterans at a time when 
our veterans are growing in numbers. With a lot of the World War II 
veterans, the Korean veterans, as well as the Vietnam veterans reaching 
that age, the demographics show there are a large number of veterans; 
and that number is increasing. So it is important for us to step up to 
the plate.
  Yes, we have provided some minimal increases throughout the years, 
but it is not sufficient. So I wanted to take this opportunity, because 
of the fact that we do have our soldiers in Iraq and Afghanistan and 
Colombia, but more so in Iraq, to just express that our thoughts and 
our prayers go out to all our soldiers that are out there, and we wish 
for their quick and safe return. We know that we are going to be 
victorious. We know we are going to be able to make that happen. We 
want that to occur as quickly as possible, and we are going to try to 
provide them with whatever resources they need. But we must also honor 
our veterans services. We honor them by ensuring that they have access 
to quality benefits and services once they come home, and that is 
important.
  With our troops in the field, and, sadly, with many Americans already 
experiencing the war's devastating effect, it is shameful that this 
House passed a budget resolution cutting $15 billion from veterans 
disability compensation programs and $9.7 billion from veterans health 
care at the same time, Mr. Speaker, that our soldiers began Operation 
Iraqi Freedom. It is clear that this proposal will have a devastating 
effect on the VA health care and benefits program, and it would serve 
as a further insult to millions of veterans already facing reductions 
in their health care, in their compensation, in their pensions and 
education benefits.
  The administration's budget was already inadequate to meet the health 
care needs of our veterans, and now the House Republicans have gone 
further and cut $844 million above the President's request for veterans 
health care next year. Not only was the President's budget inadequate, 
but the House chose to go beyond that and cut even further. The 
proposal, which was approximately $1.3 billion above the 2003 
appropriations, would not even cover the inflationary impact and 
anticipated salary increases for the VA health care workers.
  Mr. Speaker, the budget relies on unrealistic management efficiencies 
and increased copayments. Despite the fact that there are arguments 
that there was money added, it is based on certain management 
efficiencies that they are going to be able to achieve. So it is not 
even real dollars. It is based on increasing copayments for our 
veterans and a new annual enrollment tax on certain veterans using the 
VA health care system and other inefficiencies, such as eliminating 
5,000 VA nursing home vets. Mr. Speaker, that is the bill that we voted 
out, one that would cut and eliminate 5,000 nursing home beds.
  The budget resolution also calls for cutting $15 billion over 10 
years. That is $463 million just in 2004 alone in the VA mandatory 
spending under the guise of eliminating fraud, waste and abuse. Well, 
90 percent of the spending for the VA health entitlements is paid out 
of monthly payments to disabled veterans and their survivors. I 
personally do not consider payments to war disabled veterans, pensions 
for the poorest disabled veterans, and the GI bill benefits for the 
soldiers returning from Afghanistan to be fraud, waste or abuse.
  I recently joined my colleagues on the House Committee on Veterans' 
Affairs, led by our Republican colleague, the gentleman from New Jersey 
(Mr. Smith), in a bipartisan recommendation to the Committee on the 
Budget, which would have added $3 billion. So I want to thank Chairman 
Smith for his sincere effort at trying to do that, just to add for next 
year, for veterans discretionary programs, including medical care and 
research, construction, and programs that fund the administrative cost 
of other important benefits such as compensation, pension and education 
programs.
  I urge all my colleagues to do the right thing as we move forward and 
to look at this veterans budget and be able to do the right thing.
  In conclusion, as I talk about the veterans program, we also had a 
study that was done by the Secretary of Veterans Affairs, Secretary 
Principi, who I hold in great esteem; and this particular study was 
called the ``Report of the Preparedness Review Working Group to the 
Secretary of the Department of Veterans Affairs.'' This report 
basically talks about some of the problems that we are encountering and 
the need to look at how we begin to prepare ourselves in case of a 
major problem.
  Since the 9-11 attacks, the Department of Veterans Affairs has been 
forced to address issues that it never received funding to undertake. 
The VA continues to serve as a backup provider for the Department of 
Defense in times of war, and it is also part of the National Disaster 
Medical System. It is responsible for several roles within the Federal 
response plan, including providing assistance with procurement, 
assisting in the management of the national stockpile of anecdotes, 
which is key and important, and other pharmaceutical and information 
management technologies that support emergency medical care to veterans 
as well as active duty military and civilians.
  In order to fund such activities, Mr. Speaker, funds are currently 
being diverted from the VA patient care system. I had an opportunity to 
provide an amendment to the supplemental last Thursday, the 
supplemental for $77 billion. Two billion dollars of that is going for 
health care for the Iraqis; and I asked that of those $2 billion for 
the Iraqis that we look at $90 million, of which $70 million was going 
to be used to help pay for the cost that has already been incurred by 
the VA since 9-11. That was just $70 million, but I was not able to do 
that. The other $20 million was to begin to start off a piece of 
legislation that I helped author, that we passed but has not been 
funded, to establish four health centers throughout the country that 
will be able to respond for homeland defense in the area of health.
  Right now, after the study, the emergency preparedness budget that 
was sent recommended $248 million that they need now, and those dollars 
are not there. And in fact, we are taking $122 million away from 
existing services to try to do this. That is taking away from our 
veterans that need the service now that are reaching that age where 
they need us the most. In order to fund such activities, funds are 
currently being diverted. And we have to

[[Page H2856]]

stop that. We have to be able to provide the resources for homeland 
defense, to be able to get the pharmaceutical stockpiles that are 
needed for a national emergency.
  Our health care system, the VA, is one of the best in the country. It 
covers every region in the United States. And so there is a real need 
for us to provide them with the resources for the stockpile for 
pharmaceuticals that they need for antidotes and other things. They 
need not only the pharmaceuticals but they also need the training. Our 
personnel need the training. They need the resources to make that 
happen.
  Every time we go code orange or whatever the code might be, there are 
certain levels where they need a police force to fortify. They need 
security personnel that go on overtime, not to mention the fact that 
because we have gone into war we find ourselves in a situation where a 
lot of our nurses and a lot of our doctors, a lot of our health 
professionals are not only working for the VA but are in the military. 
So we are finding a great deal of difficulty in filling those slots, 
and to the point that they are looking at contracting out some of the 
services. That is why those resources are needed.
  In addition, in order to activate those four critically needed 
bioterrorist centers that would help us, we needed that $20 million. 
The VA's many areas of expertise on such diverse topics as biomedical 
research, post-traumatic stress disorders, war-related illnesses, as 
well as environmental hazards, including both treatment of 
environmental exposures such as Agent Orange, ionizing radiation, as 
well as Gulf War illnesses, make it poised to make significant 
contributions to detect and diagnose and treat a lot of our soldiers as 
well as our constituency if we ever have to. But they need the 
resources in order to make that happen.
  So I would appeal to the Members and to the Republicans to reassess 
the budget of the VA. Now, I know they will argue, and the average 
constituent out there will hear, no, we just added $122 million. They 
do not mention that the $122 million came from existing services. They 
are coming from the services that are being provided for our veterans. 
And right now is when our veterans, the numbers and the demographics 
are growing. This is when we need them the most.
  So I wanted to take this opportunity tonight to talk about health 
care, since this month is Health Care Month, and I wanted to take an 
opportunity to mention our veterans.

                              {time}  2230

  Mr. Speaker, in closing, let me say that our prayers and thoughts are 
with our soldiers. We pray for their swift and quick return back to 
their loved ones.

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